Fresh-wet storage accelerates aortic homograft calcification
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Fresh-wet storage accelerates aortic homograft calcification Piotr Podolec Æ Rafal Drwiła Æ Grzegorz Goncerz Æ Eugeniusz Rokita Æ Jerzy Sadowski Æ Wieslawa Tracz Æ Andrzej Wro´bel
Received: 30 July 2007 / Accepted: 22 October 2007 / Published online: 8 November 2007 Ó Springer Science+Business Media B.V. 2007
Abstract he studies were focused on the influence of the fresh-wet storage procedure on aortic valve homograft (AVH) mineralization. Thirty-four aortic valves excised at autopsy were investigated. The cusps were divided into halves, the first one was used as a control while the second half was stored in Morgan, Morton, and Parker’s Medium 199 supplemented with an antibiotic mixture at 4°C for 28 days. The elemental compositions of the samples were determined by the energy dispersive X-ray fluorescence method. The Ca/P ratio and Ca concentration was used as markers of the mineralization development. It was found that the AVH mineralization was accelerated by the applied fresh-wet storage procedure. The aggravation of the AVH mineralization was P. Podolec G. Goncerz W. Tracz Department of Cardiac and Vascular Diseases, Jagiellonian University, Medical College, Pra˛dnicka 80, 31-202 Krakow, Poland R. Drwiła J. Sadowski Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, Pra˛dnicka 80, 31-202 Krakow, Poland E. Rokita Department of Biophysics, Jagiellonian University, Medical College, Pra˛dnicka 80, 31-202 Krakow, Poland E. Rokita A. Wro´bel (&) Institute of Physics, Jagiellonian University, Reymonta 4, 30-059 Krakow, Poland e-mail: [email protected]
correlated with the Ca content before storage especially in case of old donors. For donors older than 40 years an increase of Ca concentrations by approximately 40% was observed. To limit AVH mineralization due to fresh-wet storage, age of donors should not exceed *40 years. Another method to reduce AVH mineralization relies on a modification of the medium commonly applied in the fresh-wet storage procedure, and research are ongoing. Keywords Aortic valve homograft Calcification Fresh-wet storage Mineralization XRF
Abbreviations AVH Aortic valve homograft XRF X-ray fluorescence SD Standard deviation Introduction Aortic valve homografts (AVHs), derived from autopsy material, have been used in clinical practice since 40 years (Ross 1965; Barrat-Boyes 1965) and implantation of an AVF is currently the procedure of choice in subsets of patients. The well-documented advantages (Gulbins et al. 2003) of the AVHs in comparison with mechanical or bioprosthetic valves are the low incidence of thromboembolism without
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anticoagulation treatment and good hemodynamic properties. In addition to problems with more demanding implantation technique compared with other valve prostheses and limited availability, the long-term durability making re-operation necessary (22% of implants fail in 15 years) constitutes the major disadvantage (Goncerz 2005). The
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